A Cross - Sectional Study on Association Between Hypothyroidism and Cholelithiasis at a Rural Tertiary Care Centre

Background: Gallstones are the most common biliary pathology, can be divided into three main types cholesterol, pigment (black, brown) or mixed stones. In India 10% are cholesterol stones, 5% are pigment stones, and 75 - 80% are mixed stones. About 80% of gallstones are asymptomatic and are detected incidentally. Thyroid disorder is a prevalent condition among adult population; however, it is frequently over looked. For decades, there has been a discussion, whether thyroid disorders could cause gallstone disease. Particularly, there are several explanations for a possible relation between hypothyroidism and gallstone disease; these explanations include the known link between thyroid failure and disturbances of lipid metabolism that may lead to changes in composition of bile. Aim and objective: To estimate TSH levels in patients who are diagnosed with cholelithiasis. To investigate the correlation between Cholelithiasis and thyroid dysfunction. Material and Method: A cross - sectional observational study conducted at Akash hospital, Devanahalli, Bengaluru rural. Consisting of 128 patients over the age of 18 diagnosed with cholelithiasis by ultrasonography. These patients were subjected to fasting serum TSH levels evaluation and were categorised into 2 cohorts based on the fasting serum TSH levels into normal thyroid function (0.35 - 3.5) and thyroid dysfunction (<0.3 to >3.5). The findings were statistically analysed using SPSS and findings are graphed. Results: Among the 128 subjects, 83 (64.8%) were female, while 45 (35.2%) were male. Within this pool, 73 patients (57%) were identified as hypothyroid and none were hyperthyroid, with peak age of 45, 85 (66.4%) were asymptomatic and the most common symptoms begin weight gain (26.6%) and weakness (23.4%). Of the 128 cholelithiasis patients 43% (55) were -asymptomatic and the most common symptom was dyspepsia 57% (73). Conclusion: The analysis highlighted a significant association between thyroid dysfunction and cholelithiasis, with a majority of patients exhibiting altered TSH levels. The prevalence of hypothyroidism was notably higher in this study compared to previous research, emphasizing the importance of considering thyroid function in the management of cholelithiasis. Investigating TSH values not only give reason for high incidence of gallstone disease and also help in overall management of patient as most patients will be subjected to surgical line of management, where in ensuring euthyroid status of the patient becomes mandatory. Moving forward, it is crucial to include thyroid function screening in the healthcare regimen of individuals diagnosed with gallstones, particularly those over 40 years old. By addressing thyroid dysfunction as a potential risk factor in patients with cholelithiasis.